What effects does lenvatinib have on the heart?

Lenvatinib (Lenvatinib) is a multi-target tyrosine kinase inhibitor (TKI), mainly used to treat hepatocellular carcinoma (HCC), thyroid cancer and renal cell carcinoma. Although the drug has significant efficacy in inhibiting tumor angiogenesis and cancer cell growth, it may also have adverse effects on the cardiovascular system, so its impact on the heart needs to be paid close attention to.

1. Hypertension: One of the most common cardiovascular side effects of lenvatinib is high blood pressure. The drug inhibits the vascular endothelial growth factor receptor (VEGFR) pathway, causing vasoconstriction and increased blood flow resistance, thereby causing an increase in blood pressure. Hypertension usually develops within days to weeks after starting treatment, so patients are advised to monitor blood pressure regularly before and during medication and adjust antihypertensive medications as appropriate.

2. Cardiac insufficiency: Some patients may develop heart failure or decreased left ventricular function while taking lenvatinib. This may be related to increased cardiac burden from hypertension, myocardial ischemia, or direct myocardial damage. If the patient develops symptoms such as shortness of breath, lower limb edema, or fatigue, cardiac function should be evaluated immediately and treatment should be adjusted or stopped if necessary.

3. QTinterval prolongation: Lenvatinib may cause QT interval prolongation and increase the risk of arrhythmias (such as torsade de pointes). Therefore, caution is needed when concomitant use of drugs that may affect the electrical activity of the heart (such as certain antibiotics or antipsychotics), and an electrocardiogram is recommended before treatment and monitored regularly during treatment.

Lenvatinib may cause heart-related side effects such as high blood pressure, heart failure, and abnormal heart rhythms. During treatment, blood pressure, electrocardiogram, and cardiac function should be monitored regularly to reduce cardiovascular risks. If the patient develops severe cardiac discomfort, the treatment plan should be adjusted promptly to ensure safety.